OUR CHEMOTHERAPY RESULTS IN PATIENTS WITH LOCALLY ADVANCED AND METASTATIC UROTHELIAL CANCER

English (OpenAlex)

This study evaluated the impact of substituting cisplatin with carboplatin in the first-line treatment and using single-agent gemcitabine as maintenance therapy on progression-free survival (PFS) and overall survival (OS) in patients with locally advanced or metastatic urothelial carcinoma who were ineligible for cisplatin. In addition, patients who received four cycles versus six cycles of cisplatin–gemcitabine or carboplatin–gemcitabine were compared. A total of 80 patients treated between January 2018 and January 2023 were retrospectively analyzed. Variables such as sex, age, tumor localization, sites of metastasis, number of chemotherapy cycles, and use of maintenance gemcitabine were evaluated. Kaplan-Meier method was used to compare survival and progression-free survival (PFS) between different clinical parameter groups, p-value <0.05 was considered statistically significant. The median OS was 23 months in female patients and 21 months in male patients. Median PFS was 46 months in males and 29 months in females, which was considered significant (p = 0.051). All patients received either cisplatin–gemcitabine or carboplatin–gemcitabine; among them, 24 patients received gemcitabine as maintenance therapy. The median PFS for the overall cohort was 6.7 months. In those who received gemcitabine maintenance, PFS was 46.7 months and considered statistically significant (p = 0.031), although no additional benefit was observed in OS. No OS difference was found between patients receiving four versus six cycles of chemotherapy; however, PFS was 18 months in patients who received four cycles compared with 59 months in those who received six cycles, which was significantly longer (p = 0.026). Maintenance therapy with gemcitabine and completing six cycles of chemotherapy may provide a favorable effect on PFS. These findings should be validated in larger, multicenter, prospective studies in advanced urothelial carcinoma.